Treatment of refractory cholestatic pruritus with molecular adsorbent recirculating system (MARS).
Transplant Proc
; 38(8): 2511-3, 2006 Oct.
Article
en En
| MEDLINE
| ID: mdl-17097984
ABSTRACT
UNLABELLED Pruritus is a common complication of cholestatic liver diseases or liver graft dysfunction. Current medical therapies lack efficacy. The molecular adsorbent recirculating system (MARS) represents an interesting therapeutic option. Our objective was to report our experience in the management of four patients with intractable pruritus with MARS. PATIENTS AND METHODS:
The MARS treatment cycle included three consecutive treatments, each of 8 hours duration. The four patients with intractable pruritus who were treated had primary biliary cirrhosis/autoimmune hepatitis overlap syndrome (n = 1), ductopenic allograft rejection (n = 2), or posttransplant cholestatic HCV recurrence (n = 1). Intensity of pruritus was documented 24 hours before as well as 24 hours, 7 and 30 days after MARS therapy, and at the end of follow-up. We measured complete blood cell counts, glucose, BUN, creatinine, sodium, potassium, AST, ALT, GGT, alkaline phosphatase, bilirubin, prothrombin activity, and activated partial thromboplastin time.RESULTS:
MARS therapy was well tolerated. Patient 1 experienced temporal relief of pruritus, but needed another MARS cycle because of relapse. Patient 2 experienced partial and temporary relief of pruritus, was listed for retransplantation, and received a liver graft 2 months later. Patient 3 showed a dramatic reduction in the degree of pruritus with MARS. Pruritus in patient 4 decreased promptly with MARS therapy and conversion of immunosuppression to tacrolimus, thereby avoiding retransplantation.CONCLUSION:
MARS therapy is a promising, safe therapeutic option to treat refractory pruritus caused by cholestatic liver disorders.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Prurito
/
Soluciones para Hemodiálisis
/
Colestasis
/
Desintoxicación por Sorción
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Trasplante de Hígado
/
Hepatopatías
Límite:
Adult
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Transplant Proc
Año:
2006
Tipo del documento:
Article
País de afiliación:
España